The ermB gene encodes an rRNA methyltransferase that modifies the macrolide–lincosamide–streptogramin B (MLSB) binding site on the 50S ribosome, conferring high-level resistance to macrolides (erythromycin, azithromycin) and often inducible resistance to clindamycin. ErmB is the most common MLSB resistance gene in streptococci and staphylococci. Detection of ermB in a clinical isolate predicts macrolide resistance and should lead clinicians to avoid these antibiotics (Roberts et al. 1999, Roberts 2008, Hotomi et al. 2009).
Roberts, M. C., Sutcliffe, J., Courvalin, P., Jensen, L. B., Rood, J., & Seppala, H. (1999). Nomenclature for macrolide and macrolide-lincosamide-streptogramin B resistance determinants. Antimicrobial agents and chemotherapy, 43(12), 2823–2830. https://doi.org/10.1128/AAC.43.12.2823
Roberts M. C. (2008). Update on macrolide-lincosamide-streptogramin, ketolide, and oxazolidinone resistance genes. FEMS microbiology letters, 282(2), 147–159.
Hotomi, M., Billal, D. S., Shimada, J., Suzumoto, M., Yamauchi, K., Fujihara, K., & Yamanaka, N. (2005). Increase of macrolide-resistant Streptococcus pneumoniae-expressing mefE or ermB gene in the nasopharynx among children with otitis media. The Laryngoscope, 115(2), 317–320.
